Results Six themes emerged from the data: (1) perceived HIV prevention landscape: prevention initiatives needed to be improved and
expanded; (2) PrEP awareness: 50 of 91 participants had heard of PrEP; (3) benefits of PrEP: one component of the combination
prevention arsenal that could help prioritise HIV prevention, empower key populations and result in economic gains; (4) challenges
of PrEP: regimen complexity, cost and cost-effectiveness, risk compensation, efficacy and effectiveness, stigmatisation and
criminalisation, information and training and healthcare system capacity; (5) programmatic considerations: user eligibility,
communication strategy, cost, distribution, medication and HIV testing compliance and (6) early versus late implementation:
participants were divided as to whether they would support an early introduction of PrEP in their country or would prefer
to wait until it has been successfully implemented in other countries, with around half of those we spoke to supporting each
option. Very few said they would not support PrEP at all.

Conclusions Despite the multiple challenges identified, there was general willingness to support the introduction of PrEP. Yet, strengthening
existing HIV prevention efforts was also deemed necessary. Our results suggest that an effective PrEP programme would be delivered
in healthcare facilities and involve non-governmental organisations and the community and consider the needs of mobile populations.
Comprehensive information packages and training for users and providers would be critical. The cost of PrEP would be affordable
and possibly segmented. Extensive counselling and innovative monitoring measures ought to be considered.

Contributors AW, ABE, GBG, EG, MRD and PP agree with the manuscript's results and conclusions. ABE and AW designed the measures/the study
with the support of EG and PP. AW, GBG and ABE reviewed the available data and literature and performed the analyses. All
authors contributed to the interpretation of results and write-up. MRD was principal investigator for the grant. PP and ABE
were investigators for the grant at Imperial College London.

Funding The sponsor of the study, the Bill & Melinda Gates Foundation, had no role in study design, data collection, data analysis
or write-up of the paper.

Competing interests The authors have declared that no competing interests exist.

Ethics approval This study was approved by the Ethics Committee of Imperial College London, the Universidad Peruana Cayetano Heredia in Peru,
the Sociological Association of Ukraine (SAU), the Independent Ethics Committee Consultants (IEC) in India, the Institutional
Review Board of the Kenya Medical Research Institute (KEMRI), the Director General Health Services of the Ministry of Health
in Uganda, the Health Research and Development Division of the Ministry of Health in Botswana and the Human Research Ethics
Committee (Medical) of the University of Witwatersrand in South Africa.